在正常流量,低梯度的大动脉狭窄症中,通过导管大动脉置换后的生活质量
Ibrahim Khaleel1, Andrew W Harris2, Milan Seth3
1Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
JACC. Advances
|June 28, 2024
概括
过导管大动脉置换 (TAVR) 改善了正常流动,低梯度大动脉狭窄症 (NF-LG AS) 患者的生活质量,类似于高梯度AS患者. 然而,NF-LG AS患者在TAVR后的死亡率较高.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 在正常流动,低梯度的大动脉狭窄症 (NF-LG AS) 的大动脉置换 (AVR) 的生存益处方面存在矛盾的结果.
- 在NF-LGAS患者中,经过过导管AVR (TAVR) 后生活质量 (QoL) 的变化仍然未得到报告.
研究的目的:
- 为了比较TAVR后NF-LGAS患者的QOL变化与高梯度AS (HG-AS) 相比.
主要方法:
- 针对严重大动脉狭窄症 (AS) 进行TAVR的患者被分为四个血液动力学概况,包括NF-LG AS.
- 堪萨斯城心肌病问卷-12分数从基线评估到1年.
- 主要综合结局被定义为为期1年的生存率和改善的QOL (KCCQ总体总结得分增加≥5分),调整为基线因素.
主要成果:
- 在860名TAVR患者中,42.8%患有HG-AS,28.5%患有NF-LGAS.
- 在HG-AS和NF-LGAS组之间,临床改善率相似 (70.4%对63.9%,P=0.189).
- 与HG-AS组相比,NF-LGAS组的一年死亡率显著更高 (12.9%),而HG-AS组 (5.8%,P<0.001).
- 在调整后的分析中,初级综合结果在组之间没有显著差异 (aOR=0.72,95% CI:0.47-1.11).
结论:
- 患有NF-LG AS的患者在TAVR后表现出与患有HG-AS的患者相似的QoL改善.
- 需要进一步的研究来优化NF-LGAS患者的TAVR选择.
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